Respiratory syncytial virus bronchiolitis in infancy is an important risk factor for asthma and allergy at age 7
Respiratory syncytial virus bronchiolitis in infancy is an important risk factor for asthma and allergy at age 7
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DOI：
10.1164/ajrccm.161.5.9906076
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发表时间：
2000-05-01
影响因子：
24.7
通讯作者：
Kjellman, B
中科院分区：
文献类型：
--
作者：
Sigurs, N;Bjarnason, R;Kjellman, B
我们先前报道了47名婴儿期因呼吸道合胞病毒（RSV）毛细支气管炎住院的儿童与93名婴儿期招募的匹配对照受试者相比，3岁以下支气管阻塞性疾病和过敏性致敏的风险增加。本研究的目的是评估这些儿童在7岁半时支气管阻塞性疾病和过敏性致敏的发生率。所有140名儿童都报告了随访，其中包括体格检查，皮肤点刺试验和常见食物和吸入过敏原的血清IgE试验。RSV组哮喘的累积患病率为30%，对照组为3%（p < 0.001），“任何喘息”的累积患病率分别为68%和34%（p < 0.001）。在随访前一年中，RSV儿童中有23%的人患有哮喘，对照组中有2%的人患有哮喘（p < 0.001）。在41%的RSV儿童和22%的对照受试者中发现过敏性致敏（p = 0.039）。对所有140名儿童使用逐步logistic统计程序对哮喘和致敏的可能风险因素进行多变量评估，结果显示RSV毛细支气管炎具有最高的哮喘独立风险比（OR：12.7，95%CI 3.4 - 47.1）和显著升高的过敏性致敏独立风险比（OR：2.4，95%CI 1.1 - 5.5）。总之，婴儿期RSV细支气管炎严重到足以导致住院治疗与7岁半之前哮喘和过敏性致敏的发生高度相关。研究结果支持RSV影响儿童哮喘和过敏发生机制的理论。
We previously reported an increased risk for bronchial obstructive disease and allergic sensitization up to age 3 in 47 children hospitalized with a respiratory syncytial Virus (RSV) bronchiolitis in infancy compared with 93 matched control subjects recruited during infancy. The aims of the present study were to evaluate the occurrences of bronchial obstructive disease and allergic sensitization in these children at age 7 1/2. All 140 children reported for the follow-up, which included physical examination, skin prick tests, and serum IgE tests for common food and inhaled allergens. The cumulative prevalence of asthma was 30% in the RSV group and 3% in the control group (p < 0.001), and the cumulative prevalence of "any wheezing" was 68% and 34%, respectively (p < 0.001). Asthma during the year prior to follow-up was seen in 23% of the RSV children and 2% in the control subjects (p < 0.001). Allergic sensitization was found in 41% of the RSV children and 22% of the control subjects (p = 0.039). Multivariate evaluation of possible risk factors for asthma and sensitization using a stepwise logistic statistical procedure for all 140 children showed that RSV bronchiolitis had the highest independent risk ratio for asthma (OR: 12.7, 95% CI 3.4 to 47.1) and a significantly elevated independent risk ratio for allergic sensitization (OR: 2.4, 95% CI 1.1 to 5.5). In conclusion, RSV bronchiolitis in infancy severe enough to cause hospitalization was highly associatied with the development of asthma and allergic sensitization up to age 7 1/2. The results support the theory that the RSV influences the mechanisms involved in the development of asthma and allergy in children.